Transfer of Composite Graft with Immediate Suture Anastomosis of Its Vascular Pedicle Measuring Less Than 1 mm. in External Diameter Using Microsurgical Techniques

1967 ◽  
Vol 40 (4) ◽  
pp. 325-329 ◽  
Author(s):  
BERISH STRAUCH ◽  
DONALD E. MURRAY
Keyword(s):  
Composite Graft ◽  
External Diameter ◽  
Vascular Pedicle ◽  
Suture Anastomosis ◽  
Microsurgical Techniques

Microsurgical Reconstruction of Partial Thumb Defects

1999 ◽  
Vol 24 (2) ◽  
pp. 161-169 ◽  
Author(s):  
S. H. WOO ◽  
J. S. KIM ◽  
H. H. KIM ◽  
J. H. SEUL
Keyword(s):  
Scar Formation ◽  
Functional Improvement ◽  
Vascular Pedicle ◽  
Great Toe ◽  
Normal Appearance ◽  
Microsurgical Reconstruction ◽  
Flap Survival ◽  
Adjacent Structures ◽  
Microsurgical Techniques

We have reconstructed thumb defects using microsurgical techniques in 43 patients. The flap survival was 100% and functional improvement with near normal appearance was obtained in the reconstructed thumbs. In order to obtain satisfactory results, donor sites were confined to the great toe and its adjacent structures and adventitia was removed from the vascular pedicle, which was transferred by subcutaneous tunnelling to minimize scar formation in the reconstructed thumb. The width of transferred nail and pulp volume were matched to the defect in the thumb before transfer.

A Practical Tip for Marking the Vascular Pedicle of a Free Flap

2020 ◽  
Author(s):  
Ahmed Emam ◽  
Giulia Colavitti ◽  
Thomas Chapman ◽  
Thomas Wright ◽  
Umraz Khan
Keyword(s):  
Free Flap ◽  
Vascular Pedicle

Constructive Optimisation of the Propeller Type Mixing Devices Using the Virtual and Rapid Prototyping

2017 ◽  
Vol 68 (3) ◽  
pp. 453-458 ◽  
Author(s):  
Daniel Besnea ◽  
Alina Spanu ◽  
Iuliana Marlena Prodea ◽  
Gheorghita Tomescu ◽  
Iolanda Constanta Panait
Keyword(s):  
Rapid Prototyping ◽  
Low Cost ◽  
Scale Up ◽  
Three Dimensional ◽  
Rapid Identification ◽  
Multidisciplinary Optimization ◽  
External Diameter ◽  
Process Industries ◽  
Parametric Cad ◽  
Shaft Torque

The paper points out the advantages of rapid prototyping for improving the performances/constructive optimization of mixing devices used in process industries, here exemplified to propeller types ones. The multidisciplinary optimization of the propeller profile affords its design using parametric CAD methods. Starting from the mathematical curve equations proposed for the blade profile, it was determined its three-dimensional virtual model. The challenge has been focused on the variation of propeller pitch and external diameter. Three dimensional ranges were manufactured using the additive manufacturing process with Marker Boot 3D printer. The mixing performances were tested on the mixing equipment measuring the minimum rotational speed and the correspondent shaft torque for complete suspension achieved for each of the three models. The virtual and rapid prototyping method is newly proposed by the authors to obtain the basic data for scale up of the mixing systems, in the case of flexible production (of low quantities), in which both the nature and concentration of the constituents in the final product varies often. It is an efficient and low cost method for the rapid identification of the optimal mixing device configuration, which contributes to the costs reduction and to the growing of the output.

scholarly journals Extradural anterior clinoidectomy in surgical management of clinoidal meningiomas

2021 ◽  
Vol 57 (1) ◽  
Author(s):  
K. El-Bahy ◽  
Ashraf M. Ibrahim ◽  
Ibrahim Abdelmohsen ◽  
Hatem A. Sabry
Keyword(s):  
Cavernous Sinus ◽  
Tumor Resection ◽  
Visual Outcome ◽  
Extent Of Resection ◽  
Optic Canal ◽  
Falciform Ligament ◽  
Cavernous Sinus Invasion ◽  
Anterior Clinoidectomy ◽  
Microsurgical Techniques

Abstract Background Despite the recent advances in skull base surgery, microsurgical techniques, and neuroimaging, yet surgical resection of clinoidal meningiomas is still a major challenge. In this study, we present our institution experience in the surgical treatment of anterior clinoidal meningiomas highlighting the role of extradural anterior clinoidectomy in improving the visual outcome and the extent of tumor resection. This is a prospective observational study conducted on 33 consecutive patients with clinoidal meningiomas. The surgical approach utilized consisted of extradural anterior clinoidectomy, optic canal deroofing with falciform ligament opening in all patients. The primary outcome assessment was visual improvement and secondary outcomes were extent of tumor resection, recurrence, and postoperative complications. Results The study included 5 males and 28 females with mean age 49.48 ± 11.41 years. Preoperative visual deficit was present in 30 (90.9%) patients. Optic canal involvement was present in 24 (72.7%) patients, ICA encasement was in 16 (48.5%), and cavernous sinus invasion in 8 (24.2%). Vision improved in 21 patients (70%), while 6 patients (20%) had stationary course and 1 patient (3%) suffered postoperative new visual deterioration. Gross total resection was achieved in 24 patients (72.7%). The main factors precluding total removal were cavernous sinus involvement and ICA encasement. Mortality rate was 6.1%; mean follow-up period was 27 ± 13 months. Conclusions In this series, the use of extradural anterior clinoidectomy provided a favorable visual outcome and improved the extent of resection in clinoidal meningioma patients.

scholarly journals Challenges in the Forging of Steel-Aluminum Bearing Bushings

Materials ◽  
2021 ◽  
Vol 14 (4) ◽  
pp. 803
Author(s):  
Bernd-Arno Behrens ◽  
Johanna Uhe ◽  
Tom Petersen ◽  
Christian Klose ◽  
Susanne E. Thürer ◽  
...  
Keyword(s):  
Intermetallic Layer ◽  
Dissimilar Materials ◽  
Intermetallic Phases ◽  
Internal Diameter ◽  
External Diameter ◽  
Forming Process ◽  
High Deformation ◽  
Eds Analysis ◽  
Steel Aisi ◽  
Metallurgical Bond

The current study introduces a method for manufacturing steel–aluminum bearing bushings by compound forging. To study the process, cylindrical bimetal workpieces consisting of steel AISI 4820 (1.7147, 20MnCr5) in the internal diameter and aluminum 6082 (3.2315, AlSi1MgMn) in the external diameter were used. The forming of compounds consisting of dissimilar materials is challenging due to their different thermophysical and mechanical properties. The specific heating concept discussed in this article was developed in order to achieve sufficient formability for both materials simultaneously. By means of tailored heating, the bimetal workpieces were successfully formed to a bearing bushing geometry using two different strategies with different heating durations. A metallurgical bond without any forging defects, e.g., gaps and cracks, was observed in areas of high deformation. The steel–aluminum interface was subsequently examined by optical microscopy, scanning electron microscopy (SEM) and energy dispersive spectroscopy (EDS). It was found that the examined forming process, which utilized steel–aluminum workpieces having no metallurgical bond prior to forming, led to the formation of insular intermetallic phases along the joining zone with a maximum thickness of approximately 5–7 µm. The results of the EDS analysis indicated a prevailing FexAly phase in the resulting intermetallic layer.

scholarly journals Primary Malignant Orbital Tumors

2021 ◽  
Vol 82 (01) ◽  
pp. 081-090
Author(s):  
Jacquelyn Laplant ◽  
Kimberly Cockerham
Keyword(s):  
Multimodal Therapy ◽  
Surgical Techniques ◽  
Surgical Approaches ◽  
Imaging Features ◽  
Orbital Surgery ◽  
Diagnosis And Management ◽  
Microsurgical Techniques ◽  
Invasive Techniques ◽  
Traditional Approaches ◽  
Orbital Imaging

Abstract Objective Primary orbital malignancy is rare. Awareness of the characteristic clinical and imaging features is imperative for timely identification and management. Surgery remains an important diagnostic and treatment modality for primary orbital malignancy, but determining the optimal surgical approach can be challenging. The purpose of this article is to explore recent advances in the diagnosis, management, and surgical approaches for primary orbital malignancies. Design In this review, the clinical presentation, imaging features, and medical and surgical management of primary orbital malignancies with representative cases will be discussed. Setting Outpatient and inpatient hospital settings. Participants Patients with diagnosed primary orbital malignancies. Main Outcome Measures Descriptive outcomes. Results Advancements in orbital imaging, microsurgical techniques, and multimodal therapy have improved the diagnosis and management of primary orbital malignancies. Special considerations for biopsy or resection are made based on the tumor's location, characteristics, nearby orbital structures, and goals of surgery. Minimally invasive techniques are supplanting traditional approaches to orbital surgery with less morbidity. Conclusions Advances in imaging technologies and surgical techniques have facilitated the diagnosis and management of primary orbital malignancies. Evolution toward less invasive orbital surgery with focus on preservation and restoration of function is underway.

scholarly journals Human Oral Mucosal Stem Cells Reduce Anastomotic Leak in an Animal Model of Colonic Surgery

2021 ◽  
pp. 1-8
Author(s):  
Ilan Kent ◽  
Cyrus Jahansouz ◽  
Amandeep Ghuman ◽  
Baruch Shpitz ◽  
Debora Kidron ◽  
...  
Keyword(s):  
Stem Cells ◽  
Anastomotic Leak ◽  
Murine Model ◽  
Colonic Anastomosis ◽  
Colon Surgery ◽  
Leak Rate ◽  
Colonic Surgery ◽  
Colon Wall ◽  
Anastomotic Leak Rate ◽  
Suture Anastomosis

<b><i>Background:</i></b> Anastomotic leak is regarded as one of the most feared complications of bowel surgery; avoiding leaks is a major priority. Attempts to reduce or eliminate leaks have included alternate anastomotic techniques. Human oral mucosa stem cells (hOMSC) are self-renewing and expandable cells derived from buccal mucosa. Studies have shown that hOMSC can accelerate tissue regeneration and wound healing. The objective of this study was to evaluate whether hOMSC can decrease anastomotic leak rates in a murine model of colon surgery. <b><i>Methods:</i></b> Two experiments were performed. In the first study, mice underwent colonic anastomosis using five interrupted sutures. hOMSC (<i>n</i> = 7) or normal saline (NS; <i>n</i> = 17) was injected into the colon wall at the site of the anastomosis. To evaluate whether hOMSC can impact anastomotic healing, the model was stressed by repeating the first experiment, reducing the number of sutures used for the construction of the anastomosis from five to four. Either hOMSC (<i>n</i> = 8) or NS (<i>n</i> = 20) was injected at the anastomosis. All mice that survived were sacrificed on postoperative day 7. Anastomotic leak rate, mortality, daily weight, and daily wellness scores were compared. <b><i>Results:</i></b> In the five-suture anastomosis, there were no differences in anastomotic leak rate, mortality, or daily weight. Mice that received hOMSC had significantly higher wellness scores on postoperative day 2 (<i>p</i> &#x3c; 0.05). In the four-suture anastomosis, there was a significant decrease in leak rate (70% [NS] vs. 25% [hOMSC], <i>p</i> = 0.029) and higher wellness scores in mice that received hOMSC (<i>p</i> &#x3c; 0.05). <b><i>Conclusion:</i></b> Our study suggests that injecting hOMSC at the colonic anastomosis can potentially reduce anastomotic leak and improve postoperative wellness in a murine model of colon surgery.

scholarly journals Association of changes of retinal vessels diameter with ocular blood flow in eyes with diabetic retinopathy

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yoshitaka Ueno ◽  
Takeshi Iwase ◽  
Kensuke Goto ◽  
Ryo Tomita ◽  
Eimei Ra ◽  
...  
Keyword(s):  
Blood Flow ◽  
Diabetic Retinopathy ◽  
Adaptive Optics ◽  
Laser Speckle ◽  
The Other ◽  
Systemic Hypertension ◽  
Laser Speckle Flowgraphy ◽  
Retinal Vessels ◽  
External Diameter ◽  
The Mean

AbstractWe investigated morphological changes of retinal arteries to determine their association with the blood flow and systemic variables in type 2 diabetes patients. The patients included 47 non-diabetic retinopathy eyes, 36 mild or moderate nonproliferative diabetic retinopathy (M-NPDR) eyes, 22 severe NPDR (S-NPDR) eyes, 32 PDR eyes, and 24 normal eyes as controls. The mean wall to lumen ratio (WLR) measured by adaptive optics camera was significantly higher in the PDR groups than in all of the other groups (all P < 0.001). However, the external diameter of the retinal vessels was not significantly different among the groups. The mean blur rate (MBR)-vessel determined by laser speckle flowgraphy was significantly lower in the PDR group than in the other groups (P < 0.001). The WLR was correlated with MBR-vessel (r = − 0.337, P < 0.001), duration of disease (r = 0.191, P = 0.042), stage of DM (r = 0.643, P < 0.001), systolic blood pressure (r = 0.166, P < 0.037), and presence of systemic hypertension (r = 0.443, P < 0.001). Multiple regression analysis demonstrated that MBR-vessel (β = − 0.389, P < 0.001), presence of systemic hypertension (β = 0.334, P = 0.001), and LDL (β = 0.199, P = 0.045) were independent factors significantly associated with the WLR. The increased retinal vessel wall thickness led to a narrowing of lumen diameter and a decrease in the blood flow in the PDR group.

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